Individual provider Active NPI

Shauna Fung, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brooklyn, NY
National Provider Identifier
1467659490
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
050354-1 Issued in NY
Practice address
738 58TH St Ste 1
Brooklyn, NY 11220-5171
Phone
(212) 966-9628
Fax
(347) 966-8699
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 050354-1 NY Primary

Addresses

Primary practice location

738 58TH St Ste 1
Brooklyn, NY 11220-5171

Mailing address

738 58TH St Ste 1
Brooklyn, NY 11220-5171
Phone (212) 966-9628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
050354-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
SFC Orthodontics P.C. Orthodontics and Dentofacial Orthopedics CurrentSince Feb 9, 2020 Accepting new patients
SF Orthodontics PC Orthodontics and Dentofacial Orthopedics CurrentSince May 21, 2023 Accepting new patients

Locations

738 58th St
Ste 1
Brooklyn, NY 11220
Phone (212) 966-9628

70 Bowery
Rm 302
New York, NY 10013

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1467659490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 58TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205171",
            "telephone_number": "212-966-9628",
            "fax_number": "347-966-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 58TH ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205171",
            "telephone_number": "212-966-9628",
            "fax_number": "347-966-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "SHAUNA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "050354-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.